Papilledema and acute bilateral amaurosis accompanying acute sinusitis.

Background: Acute sinusitis can lead to severe complications. This includes involvement of the optical nerve with visual loss and brain abscess as a l ife-threatening complication. Patients: Empyema of the chiasma opticum region with neuritis nervi optici and bilateral acute amaurosis was observed in a 13 year old boy with sinusi tis sphenoidalis and ethmoidalis. In a 11 year old girl, pronounced papille dema was found to be closely associated with sinusitis sphenoidalis. While she recovered completely on appropriate antibiotic therapy, visual loss in the boy was irreversible despite surgical intervention. Conclusions: Sinusitis should always be considered in patients with impaire d vision, neuritis nervi optic! or unexplained papilledema, especially if o ccurring in association with an upper respiratory infection. In addition to physical examination, cranial computer tomography or magnetic resonance im aging of the brain including sinuses and chiasma opticum should be applied early. If empyema is found, immediate surgical intervention is of prognosti c importance.